Alopecia areata, orange peelings

DEAR DR. DONOHUE: I have had alopecia areata for the past two and a half years. It affects my scalp and beard. It comes and goes. I see my dermatologist every two months. Is there any cure? -- M.B.

ANSWER: Round-to-oval bald patches are the signature of alopecia areata. They're found on the scalp and sometimes on the eyebrows or beard, or the legs or arms. About 1 percent of the population suffers from it. It strikes women and men in equal numbers and is found in all races.

The cause is probably an immune attack by the body on its own hair follicles. What sets off the attack is something yet to be explained. Often, alopecia areata runs in families. Sometimes it's seen in association with other illnesses, like type 1 diabetes, lupus, asthma or thyroid gland inflammation.

The course alopecia areata takes is unpredictable. Many see a regrowth of hair in one year without any treatment. A small percentage have to deal with it on a more or less constant basis. Most suffer from relapses after they have had a recovery.

What can be done depends on the size of the bald spots and their number. For a few, small patches of cortisone drugs applied to the bald spots can sometimes coax hair to grow back. Minoxidil (Rogaine) comes in liquid form and can also restore hair for some. The doctor can inject the bald patches with a cortisone drug to kick-start hair regrowth.

For larger and more numerous bald spots, the above methods can be used, but medicines that moderate the immune attack are often effective. DPCP is an example of one of those medicines.

DEAR DR. DONOHUE: I was wondering if I was ruining the principle of eating an orange by peeling off the white covering left after an orange's skin is removed. Am I throwing away precious nutrients? -- Anon.

ANSWER: I don't know what that white stuff is, but I always get rid of it. I don't like the looks or the taste of it. I'm positive we're not throwing away precious nutrients. Maybe a little fiber, but we can get fiber in other ways.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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